Mucin-producing sweat gland carcinoma of the eyelid: diagnostic and prognostic considerations

Am J Ophthalmol. 2013 Mar;155(3):585-592.e2. doi: 10.1016/j.ajo.2012.09.030. Epub 2012 Dec 4.

Abstract

Purpose: To describe the clinical and pathologic characteristics of mucin-producing sweat gland carcinoma of the eyelid and to determine whether neuroendocrine differentiation is of prognostic significance.

Design: Retrospective interventional case series.

Methods: Search of the New York Eye and Ear Infirmary pathology database between 1990 and 2011 identified 16 patients with mucin-producing sweat gland carcinoma. Clinical, histopathologic, and immunohistochemical analyses were performed on all identified cases.

Results: The patients presented with vascularized, focally cystic, nonulcerated eyelid margin lesions. Histopathologic evaluation showed that 4 lesions (25%) had a cystic, papillary, and solid growth pattern with an in situ component, 7 (44%) were pure invasive mucinous carcinomas, and 5 (31%) demonstrated both growth patterns. Immunohistochemical analysis of 15 tumors showed that pure cystic/papillary lesions had a significantly greater percentage of synaptophysin-immunoreactive cells (P = .036). There was no significant difference in the number of neuroendocrine markers expressed or in the intensity of immunostaining among the 3 different growth patterns. Re-excision for margin clearance was performed in 8 of 13 cases (61.5%). Two of 13 lesions recurred (15%); 1 of these was an in situ tumor with cystic morphology and neuroendocrine differentiation and the other was pure invasive mucinous carcinoma. None of the lesions metastasized.

Conclusions: Mucin-producing sweat gland carcinoma pathologically represents a continuum, from an in situ lesion to a classic, invasive mucinous carcinoma. Immunohistochemical evidence of neuroendocrine differentiation can be observed in all lesions and does not appear to have a prognostic significance, arguing against the utility of immunohistochemical subtyping of mucinous sweat gland carcinomas.

MeSH terms

  • Adenocarcinoma, Mucinous / chemistry
  • Adenocarcinoma, Mucinous / diagnosis*
  • Adenocarcinoma, Mucinous / metabolism
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis
  • Carcinoma in Situ / diagnosis
  • Carcinoma, Basal Cell / diagnosis
  • Diagnosis, Differential
  • Eyelid Neoplasms / chemistry
  • Eyelid Neoplasms / diagnosis*
  • Eyelid Neoplasms / metabolism
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Mucins / metabolism*
  • Prognosis
  • Retrospective Studies
  • Sweat Gland Neoplasms / chemistry
  • Sweat Gland Neoplasms / diagnosis*
  • Sweat Gland Neoplasms / metabolism

Substances

  • Biomarkers, Tumor
  • Mucins